Medicare fee schedule by locality · Q3 2026 release
Massachusetts
Massachusetts has 2 Medicare payment localities, each with its own GPCIs — the work GPCI alone ranges from 1.016 to 1.041 across the state. National amounts use GPCI 1.000. Every row below shows what a common code pays once each locality's real GPCIs apply.
Localities in Massachusetts
99213 non-facility amount by locality, Q3 2026 (before sequestration) — national baseline $95.19.
| Locality | Work GPCI | PE GPCI | MP GPCI | 99213 amount |
|---|---|---|---|---|
| Metropolitan Boston | 1.041 | 1.194 | 0.890 | $106.10 (+11.5%) |
| Rest of Massachusetts | 1.016 | 1.053 | 0.797 | $97.86 (+2.8%) |
Need a different code or the facility rate? Use the rate calculator with any locality above selected.
Common questions
How many Medicare payment localities are in Massachusetts?
Massachusetts has 2 Medicare payment localities, each with its own work, practice-expense, and malpractice GPCIs.
Do Medicare rates vary within Massachusetts?
Yes. Massachusetts's 2 localities have different GPCIs — the work GPCI alone ranges from 1.016 to 1.041. The same code can therefore pay a different amount depending on where in the state it's billed.
Source & method
GPCIs and example rates computed from the CMS Medicare Physician Fee Schedule Q3 2026 release. Example amounts take the national non-facility figures and rescale them by each locality's GPCIs, before the ~2% sequestration cut. Releases are immutable: a rate retrieved for a past quarter always reflects that release.
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